Data is lacking on the reliability of weight and height for young children as reported by parents participating in population-based studies. We analysed the accuracy of parental reports of children's weights and heights as estimates of body mass index, and evaluated the factors associated with the misclassification of overweight and obese children.
Analyses were conducted on a population-based birth cohort of 1549 4-year-old children from the province of Québec (Canada) in 2002. Mothers reported weights and heights for the children as part of the regular annual data collection. Within the following 3 months, children's weights and heights were measured at home as part of a nutrition survey.
This study indicates that mothers overestimate their children's weight more than their height, resulting in an overestimation of overweight children of more than 3% in the studied population. Only 58% of the children were reported as overweight/obese with reported values. Maternal misreporting is more important for boys than girls, and for low socioeconomic status children compared with high socioeconomic status children.
Research on the prevalence of overweight and obesity has often used self-reported measures of height and weight to estimate BMI. However, the results emphasize the importance of collecting measured data in childhood studies of overweight and obesity at the population level.
With the introduction of an anti-haemophilus type B vaccine, a standard incidence rate for acute epiglottitis is needed to judge its efficacy. Epiglottitis is thought to be more common in children than in adults, but this relation has never been clearly established. This article attempts to evaluate the incidence of this disease. A review of the literature regarding the incidence is correlated to new data from the 1981 Census of Canada and the Med-Echo System of the province of Quebec. It suggests that the incidence rate is approximately 60/million for children (1/17,000), whereas it is 10/million for adults (1/103,000). These rates are based on the analysis of 712 pediatric cases and 257 adult cases. After a review from various sources, my estimation is that a slightly lower than 3-to-1 ratio of cases is probable between the pediatric and adult cases of acute epiglottitis.
OBJECTIVES: The Inuit of Nunavik in northern Quebec have a lower risk for ischemic heart disease (IHD) compared to Caucasian populations. Acylation stimulating protein (ASP), which is involved in the storage of dietary fat, may play a role. The objective of the study was to determine plasma concentration of ASP in an Inuit and a southern Quebec Caucasian population. STUDY DESIGN: This is a cross-sectional study evaluating the relationship between ASP and dietary factors, such as retinol, whose intake is higher in the Inuit. As well, concentrations of ASP were evaluated in relationship to components of the metabolic syndrome. METHODS: Medical history was collected via a questionnaire and anthropometric measurements and blood samples were collected. RESULTS: ASP was significantly higher in both the Inuit men and women compared to Caucasian men (66.1 +/- 4.1 nM vs 27.5 +/- 2.5 nM, p
RefSource: Int J Circumpolar Health. 2009 Dec;68(5):419-20
Though high discontinuation rates for antipsychotics (APs) by patients with schizophrenia are frequently reported, the percentage of patients receiving pharmaceutical treatment for schizophrenia in routine practice in accordance with international clinical guidelines is unknown. Further, it is unknown if these rates are influenced by levels of neighbourhood deprivation or by a patient's age or sex. Our study aims to investigate if inequalities in AP treatment could be observed between patients living in neighbourhoods with the highest levels of material and social deprivation and those with the lowest deprivation levels, between patients from different age groups, or between men and women.
We conducted a secondary analysis of medical-administrative data of a cohort of adult patients in the province of Quebec with a medical contact for schizophrenia in a 2-year period (2004-2005). We assessed the proportion of patients that filled at least 1 prescription for an AP and received adequate pharmaceutical treatment, defined as being in possession of APs at least 80% of the time as outpatients during a 2-year follow-up period.
Among the 30 544 study patients, 88.5% filled at least 1 prescription for an AP, and 67.5% of the treated patients received adequate treatment. Though no clinically significant differences were observed by deprivation or sex, younger age was associated with lower proportions of patients receiving adequate treatment (46% of treated patients aged between 18 and 29 years, compared with 72% aged between 30 and 64 years, and 77% aged 65 years and over).
In Quebec's routine practice, over 70% of treated patients aged 30 and over received adequate pharmacological treatment, regardless of sex or neighbourhood socioeconomic status. In contrast, in patients aged between 18 and 29 years this percentage was 47%. This is a discouraging finding, especially because optimal treatment in the early phase of disease is reported to result in the best long-term outcomes.
To study alcohol and drug addiction incidence in students exposed to the Dawson College shooting within the 18 months following the event, to identify the precursors of a psychoactive substance addiction development while considering the severity of event exposure, and to examine whether alcohol use, 18 months after the event, is related to any of the various posttraumatic stress disorder (PTSD) symptom groups.
The population of this study was comprised of all the Dawson College students at the time of the event. Analyses were conducted with 854 students enrolled in the college at the time of the shooting.
Five per cent of women and 7% of men showed, for the first time in their life, a problem with substance addiction following the shooting. In men, young age, lifetime suicidal ideation, and having seen the killer during the shooting are the main precursors of incident accident cases. None of the studied precursors were significant in women. Men and women were also different in terms of PTSD symptoms predicting alcohol use 18 months after the shooting.
The study highlights the importance of considering a person's sex when studying their psychoactive substance use following a trauma.
Researchers and public health officials in Canada, the United States and Australia have for some time noted broader geographic accessibility to gambling establishments, above all in socioeconomically underprivileged communities. This increase in availability could lead to more and more gambling problems. This article focuses, in an ecological perspective, in particular on a spatial analysis of the geographic accessibility of sites possessing a VLT permit in the Montréal area, i.e. Montréal Island, the South Shore and Laval, from the standpoint of the development of an indicator of the vulnerability (socioeconomic components and demographic components) to gambling of populations at the level of certain neighbourhood units (dissemination areas). With the recent development of geographic information systems (GIS), it is now possible to ascertain accessibility to services much more accurately, for example by taking into account the configuration of the road network.
The findings of our analysis reveal widespread geographic accessibility to sites possessing a VLT permit in the downtown area and in pericentral districts. In some neighbourhood units, a site possessing a VLT permit may be within a three-minute walk. In the region studied overall, average walking time to a VLT site is nine minutes. Access to this type of service on foot is usually limited in the outskirts. However, a number of groups of sites possessing VLT permits are found along certain axial highways. According to local spatial self-correlation analyses, the findings suggest a significant link between walking accessibility to sites possessing VLT permits and the vulnerability of the communities. In a number of neighbourhood units with ready access to VLT's the populations display high vulnerability.
These findings reveal that accessibility to sites possessing a VLT permit is often linked to the vulnerability (socioeconomic and demographic components) of communities. Reliance in our analyses on neighbourhood units with fairly small areas enabled us to emphasize the rectilinear dimension of the spatial distribution of sites possessing VLT permits. This is a significant link that public health officials must consider when elaborating programs to combat pathological gambling.
Cites: J Epidemiol Community Health. 2001 Feb;55(2):111-2211154250
We prospectively tested the extent to which witnessing school violence predicts psychosocial and school adjustment in students while accounting for their prior psychosocial characteristics and peer victimization. We also explored the role of feelings of insecurity in explaining this relationship.
Questionnaires were administered to 1104 students (52% boys) from five high schools from the Montreal area (Quebec, Canada) at the beginning, middle, and end of seventh grade. Self report measures included sociodemographic characteristics, victimization, witnessing violence, feelings of insecurity, internalizing and externalizing behavior problems, and measures of engagement, achievement, and truancy as indicators of school adjustment.
Witnessing school violence was a comparatively better predictor of subsequent externalizing problems and school adjustment than actual victimization. Conversely, relative to having experienced violence as a witness, actual victimization more reliably estimated later internalizing problems. Feelings of insecurity partially explained the development of school engagement and truancy.
Our findings underscore the implications of school violence as a public health and safety issue, the consideration of witnessing as important in estimating its impact, and a comprehensive approach when developing and implementing strategies that aim to prevent this form of community violence.
Specialized, multidisciplinary clinics improve service provision and reduce morbidity for patients with congestive heart failure (CHF). Although sex-related differences in access to cardiac health services have been reported, it remains unclear whether there are sex-related differences in the use of these specialized services.
To evaluate possible sex-related differences in severity at entry into specialized, multidisciplinary clinics, and compare prescription patterns between male and female patients at these clinics.
Data were obtained from the electronic clinical files of 765 CHF patients newly admitted to any of three main CHF clinics in Montreal, Quebec. Univariate and multivariate models were used to compare differences between sexes.
Only 27.1% of patients were female. The mean age (+/- SD) of the women in the present study was similar to that of the men (64+/-16 years versus 65+/-13 years, respectively). Left ventricular ejection fraction at entry for patients with reduced systolic function was comparable between sexes. The New York Heart Association functional class at entry was similar among men and women with systolic dysfunction. However, among patients with preserved systolic function, women were more symptomatic, with a higher functional class at entry (adjusted OR 2.52, 95% CI 1.18 to 5.38). Prescription profiles were similar for men and women.
Entry into a clinic may be delayed for women with preserved systolic function CHF. However, clinic referral patterns and disease management appeared to be similar among both men and women with systolic dysfunction CHF.
Cites: Eur Heart J. 2000 May;21(9):699-70010739720
To evaluate the association between rofecoxib, celecoxib, diclofenac, and ibuprofen and the risk of hospitalization for acute myocardial infarction (AMI) in an elderly population.
We conducted a retrospective cohort study, using data from the government of Quebec health insurance agency databases, among patients 65-80 years of age who filled a prescription for any of the study drugs during 1999-2002. Cox regression models with time-dependent exposure were used to compare the incidence rates of hospitalization for AMI adjusting for patients' baseline characteristics. Analyses stratified by dose and number of supplied days were also conducted.
At the index date, a total of 91 062 patients were taking rofecoxib, 127 928 celecoxib, 49 193 diclofenac, and 15 601 ibuprofen. The adjusted hazard ratio (HR) (95%CI) of hospitalization for AMI were: celecoxib versus rofecoxib: 0.90 (0.79, 1.01); ibuprofen versus rofecoxib: 0.95 (0.65, 1.37); diclofenac versus rofecoxib: 1.01 (0.84, 1.22). In secondary analyses based on intended duration of use, neither COX-2 selective inhibitor was associated with a higher risk than ibuprofen or diclofenac. The unadjusted risk of AMI for all NSAIDs increased with dose. In the direct two way adjusted comparison of each NSAID stratified by dose, the only statistically significant difference was with rofecoxib >25 mg/day versus celecoxib >200 mg/day.
In this study there was no difference between AMI occurrence in elderly patients taking rofecoxib or celecoxib at recommended doses for chronic indications versus those taking ibuprofen/diclofenac. However, the risk of AMI was higher among patients using higher doses of rofecoxib (>25 mg/day) compared to patients using higher doses of celecoxib (>200 mg/day).
Increased consumption of lake fish was associated with higher blood mercury concentrations among 289 residents of Southwest Quebec living on the southern bank of the Upper St. Lawrence River System. This increase in blood mercury was reflected in the organic fraction and to a lesser extent with total blood mercury. Repeat analyses on a small subpopulation showed a correlation coefficient between time 1 and time 2 of approximately 0.7 for total mercury and for organic mercury. With one exception, blood total mercury concentrations were less than 5 ppb. Blood mercury concentrations were higher among men than women. One individual had much higher total mercury concentrations in blood (i.e., 70 ppb) which were attributed to fish consumption based on medical and dietary history. The values for these subjects are compared with other North American data on blood mercury levels.